Study on Influencing Factors of Breast Cancer Patients Hospitalization Costs in a Tertiary Hospital in Guangzhou
Objectives To analyze the composition of hospitalization costs and the influencing factors for inpatients with breast cancer,provide data support and reference for the rational reduction of hospitalization costs and the formulation of cost control measures.Methods To collect the information of front page of medical records for 20,529 breast cancer patients from a tertiary hospital in Guangzhou,spanning the period from January 1st,2018,to December 31st,2022.The Shapley value decomposition was used to analyze the influencing factors and their contribution rate of hospitalization costs,while gray relational analysis assessed the correlation between hospitalization costs and individual cost items.Results The results of non-parametric test showed that there were statistical differences among age,discharge year,case type,hospitalization frequency,hospitalization days,surgery,drug proportion,reimbursement ratio and hospitalization expenses(P＜0.05).The average hospitalization cost for breast cancer patients was 17040.26,which was dominated by the cost of medication(50.76%),with a downward trend in all costs over the years,and the expenses showed a decreasing trend year by year.Gray relation analysis showed drug costs had the highest correlation with hospitalization costs(correlation coefficient:0.9932),followed by medical service costs(0.9930)and nursing costs(0.781).The Shapley value decomposition results showed that the length of hospitalization had the highest contribution rate to the hospitalization expenses of breast cancer patients(64.14%),followed by whether to undergo surgery(19.09%),number of hospitalizations(6.02%),case classification(4.19%),drug proportion(3.07%).Conclusions Reducing the proportion of drug costs and shortening the length of hospital stays were the priority to control hospitalization costs.Hospitals should standardize the prescribing practices of physicians,improve clinical pathways,and optimize treatment processes to minimize ineffective hospital days before and after surgery,thereby reducing the overall inpatient costs.
Breast cancerHospitalization costsInfluencing factorsShapley value decomposition
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万方数据
